TARGIT IORT with Intrabeam radiotherapy system for breast cancer

Intrabeam TARGIT IORT is a method of giving radiotherapy for breast cancer that is focussed to the tumour bed and spares other tissues and organs.

“The most important benefit of TARGIT for a woman with breast cancer is that it allows her to complete her entire local treatment [lumpectomy and radiation therapy] at the time of her operation, with lower toxicity.”

The TARGIT technique uses the Intrabeam device for delivering precise and timely dose of intraoperative radiotherapy accurately to the tumour bed.

An academic insight led to the development of this device through a collaborative effort between University College London and the Photoelectron Corporation in 1990s.

It was first used on 2 July 1998 in the Middlesex Hospital, UCL, London. Intrabeam is currently manufactured by Carl Zeiss

The Intrabeam TARGIT IORT method has been rigorously tested in the ransomised TARGIT-A trial in which 3451 patients from 33 centres in 11 countries participated. Intrabeam TARGIT IORT given during the cancer operation was compared with the traditional radiation therapy given daily over several weeks after the operation.

About 70% of patients with breast cancer are eligible for breast-conserving surgery (a lumpectomy), after which the remaining breast is treated with radiotherapy; this avoids a full mastectomy. Traditionally, external beam radiotherapy (EBRT) is delivered to the entire breast in small doses every day for 3– 6 weeks, necessitating patients to travel to and from the radiotherapy centre every working day. This can be impractical and strenuous.

The TARGIT (TARGeted Intraoperative radioTherapy) procedure precisely delivers radiation in a single dose during the lumpectomy operation over 15– 35 minutes, using a ball-shaped device that is placed in the space where the tumour was. This way, unnecessary potentially harmful radiation to healthy tissues (skin, heart, lungs, etc.) is avoided and the areas nearest to the tumour site receive the most radiation. In this way, four-fifths of patients avoid EBRT altogether.

The TARGIT-A (TARGeted Intraoperative radioTherapy Alone) trial compared TARGIT with EBRT in 3451 patients who were aged≥ 45 years and found that, when TARGIT is given with lumpectomy, the control of breast cancer is much the same as with EBRT. The chances of being alive without return of cancer in the breast at 5 years were 93.9% with TARGIT during lumpectomy and 92.5% with EBRT. Compared with EBRT, TARGIT had fewer side effects and fewer deaths from heart attacks or other cancers. TARGIT would be less expensive than EBRT, potentially saving the NHS up to £9.1 million a year, without considering the cost savings to patients.

Targeted intraoperative radiotherapy during lumpectomy is an effective, safer and less expensive option for eligible patients.

The TARGIT trial office has received its main funding from the Health Technology Assessment programme of the National Institutes of Health Research, Department of Health, UK for the TARGIT-A and TARGIT-B trials

TARGIT investigators at the – 10-year International Steering Committee meeting in 2010